Provider Demographics
NPI:1669760435
Name:NAGLE DENTAL OFFICE PC
Entity type:Organization
Organization Name:NAGLE DENTAL OFFICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:V
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-304-4935
Mailing Address - Street 1:69 NAGLE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-1405
Mailing Address - Country:US
Mailing Address - Phone:212-304-4935
Mailing Address - Fax:212-304-4936
Practice Address - Street 1:69 NAGLE AVE STE A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-1405
Practice Address - Country:US
Practice Address - Phone:212-304-4935
Practice Address - Fax:212-304-4936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty